Association between smoking and the peripheral vestibular disorder: a retrospective cohort study.

Common inner ear diseases include peripheral vestibular disorder (PVD) and hearing impairment. The association between smoking and peripheral vestibular disorder (PVD) is unclear. We examined associations between smoking and new PVD events. In this retrospective study, we consecutively enrolled 393 participants aged ≥20 years [mean age 65.3 years; males 133 (33.8%)] treated for hypertension, dyslipidaemia, or diabetes mellitus at a primary care clinic between November 2011 and March 2013. Participants were categorized as ever-smokers (including current and past -smokers; divided per <30 and ≥30 pack-years), and never-smokers. New PVD events were reported over a 1-year follow-up period. Hazard ratios (HR) for new onset PVD were estimated using the Cox proportional hazard regression model. Compared to never-smokers, the adjusted HR was 2.22 for ever-smokers and 2.70 for all ever-smokers with ≥30 pack-years among all 393 participants. Among male participants, compared to never-smokers, the adjusted HR was 4.41 for ever-smokers with ≥30 pack-years. A smoking history of ≥30 pack-years was strongly associated with the risk of new onset PVD in males but not, females. This study may assist patients with smoking cessation for the prevention of new PVD events among males.

Carotid plaque is a new risk factor for peripheral vestibular disorder: a retrospective cohort study.

Many chronic diseases are associated with dizziness or vertigo, as is peripheral vestibular disorder (PVD). Although carotid plaque development is linked to atherosclerosis, it is unclear whether such plaques can lead to the development of PVD. We therefore conducted this study to investigate the presence of an association between carotid plaque and new PVD events.In this retrospective study, we consecutively enrolled 393 patients ≥20 years old who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for ≥6 months at a primary care clinic (Oki Clinic, Japan) between November 2011 and March 2013. Carotid plaque presence was measured with high-resolution ultrasonography for all patients. During a 1-year follow-up period, an otorhinolaryngologist diagnosed and reported any new PVD events (the main end point). Hazard ratios (HRs) and 95% confidence intervals (CIs) for new PVD occurrence were estimated using the Cox proportional hazard regression model.The mean age of the participants was 65.5 years; 33.8% were men, and 12.7%, 82.4%, and 93.1% had diabetes mellitus, hypertension, and dyslipidemia, respectively. There were 76 new PVD events; patients with carotid plaque had a greater risk of such events (crude HR: 3.25; 95% CI: 1.62-6.52) compared to those without carotid plaque. This risk was even higher after adjusting for traditional risk factors for atherosclerosis (adjusted HR: 4.41; 95% CI: 1.75-11.14).Carotid plaques are associated with an increased risk of new PVD events.

Incidence of dizziness and vertigo in Japanese primary care clinic patients with lifestyle-related diseases: an observational study.

OBJECTIVE: Dizziness and vertigo are highly prevalent symptoms among patients presenting at primary care clinics, and peripheral vestibular disorder (PVD) is their most frequent cause. However, the incidence of PVD has not been well documented. This study aimed to investigate the incidence of dizziness, vertigo, and PVD among patients presenting at a primary care clinic. DESIGN: This was an observational study. SETTING AND PARTICIPANTS: Between November 2011 and March 2013, we observed 393 patients, all at least 20 years old, who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for at least 6 months at a primary clinic (Oki Clinic) in Japan. OUTCOME: The main outcome of interest was new incidence of dizziness, vertigo, and PVD events. During the 1-year follow-up period, the otorhinolaryngologist diagnosed and reported new PVD events. RESULTS: The mean age of the 393 participants at entry was 65.5 years. Of the study participants, 12.7%, 82.4%, and 92.6% had diabetes mellitus, hypertension, and dyslipidemia, respectively. We followed up all the participants (100%). During the 662.5 person-years of follow-up, 121 cases of dizziness or vertigo (dizziness/vertigo) and 76 cases of PVD were observed. The incidence of dizziness/vertigo and PVD was 194.7 (95% confidence interval: 161.6-232.6) per 1,000 person-years and 115.7 (95% confidence interval: 92.2-142.6) per 1,000 person-years, respectively. There were 61 cases of acute peripheral vestibulopathy, 12 of benign paroxysmal positional vertigo, and three of Meniere's disease among the 76 PVD patients. CONCLUSION: We reported the incidence of dizziness/vertigo among Japanese primary care clinic patients, which was higher than that usually observed in the general population. Furthermore, we described the incidence of PVD and found that it was a major cause of dizziness/vertigo.

Evoked potentials to gustatory stimulations in cases with unilateral facial nerve palsy.

Evoked potentials to taste stimulations were discussed. New our technique of objective measurement of gustatory function by an evoked potential technique will be introduced. As a result, introduction of taste solution on the tongue innervated by facial nerve in normal subjects resulted in positive responses. Absence of taste solution did not resulted in the positive response. In case with unilateral; facial nerve palsy, introduction of taste solution on the affected side did not resulted in the positive responses.

Inner-ear function test in cases of posterior canal-type benign paroxysmal positional vertigo.

Otolaryngologists typically perform diagnoses and offer medical treatment for vestibular dysfunction. This vestibular dysfunction manifests as benign paroxysmal positional vertigo (BPPV), Ménière's disease, vestibular neuronitis, and so on. The etiology of BPPV is still not clear, so in this article we discuss inner-ear function, etiology, and factors related to BPPV. We examined by pure-tone audiometry and hot and cold caloric tests patients whom we identified as having diagnosed posterior canal-type BPPV. We observed canal paresis at a high rate on the affected side (p < .01). The term of recovery at the first treatment was longer in patients with canal paresis as compared to those without. Deterioration of hearing level was observed more frequently on the affected side (p < .01). The horizontal semicircular canal and cochlea are important potential sites of lesions affecting posterior canal-type BPPV, and the posterior circular canal and otolith are already considered to be sites of affecting lesions.

Correlation between arteriosclerotic changes and prognosis in patients with peripheral vestibular disorders.

Symptoms such as vertigo and unsteady gait occur in various diseases and are among the relatively common chief complaints. Even at present, the mechanisms underlying these disorders are unclear. We report a significant correlation between a prolonged period of resolution of benign paroxysmal positional vertigo (BPPV) and histories of lifestyle-related illnesses. We consider the possibility of correlating between BPPV prognosis and arteriosclerotic changes. Using carotid ultrasonography, we examined maximum intima-media thickness (IMT), maximum common carotid artery IMT, and biochemical examinations in 105 patients with peripheral vertigo. We divided patients with BPPV into groups with and without abnormal thickness of the IMT. The maximum IMT was 1.35 mm in patients with peripheral vestibular disorders. The proportion of peripheral vestibular disorder patients with a maximum IMT of > or = 1.1 mm (i.e., thickening) was 58%. The rate at which the feeling of positional vertigo remained at the halfway point in the observation period was significantly higher in the group of patients with an IMT of > or =1.1 mm (p = .0007). Our results indicate that cervical ultrasonography is useful for noninvasive examination of arteriosclerotic changes in patients with peripheral vestibular disorders. We saw indications that such patients show progression of arteriosclerotic changes. This study suggested that the arteriosclerotic change was related to prognosis.

Arteriosclerotic changes as background factors in patients with peripheral vestibular disorders.

Symptoms such as vertigo and unsteady gait occur in various diseases and are among the relatively common chief complaints. Even at present, the mechanisms underlying these disorders are unclear. We considered the possibility of peripheral vestibular disorders correlating with lifestyle-related illnesses. Under these circumstances, we assessed correlations of lifestyle-related illness as background factors for peripheral vestibular disorders and associated arteriosclerotic changes. Using carotid ultrasonography, we assessed maximum intima-media thickness (max IMT) and maximum common carotid artery IMT and evaluated biochemical examinations in 85 patients with peripheral vertigo. The patients were divided into two groups: those with benign paroxysmal positional vertigo (BPPV) and those with peripheral vestibular disorders. The frequency of abnormal IMT was significantly higher in those in the BPPV group. Calculating for average age, max IMT was significantly higher in the BPPV group. The correlation coefficient between age and max IMT was 0.343 (p < .001). All other correlation coefficients also reached statistical significance. Our results indicate that cervical ultrasonography is useful for noninvasive examination of arteriosclerotic changes in patients with peripheral vestibular disorders. Our results also indicated that peripheral vestibular disorder patients show progression of arteriosclerotic changes.